Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Face and construct validity of a novel simulator for microsurgical education: Microsurgery Arena","authors":"Francesco Costa ,&nbsp;Alberto Ballestín ,&nbsp;Jeyaram Srinivasan ,&nbsp;Nicola Baldini ,&nbsp;Pietro G. di Summa","doi":"10.1016/j.bjps.2025.02.051","DOIUrl":"10.1016/j.bjps.2025.02.051","url":null,"abstract":"<div><div>Simulation in microsurgery is essential for skill acquisition and maintenance. This study evaluated the construct and face validity of the Microsurgery Arena, a low-fidelity simulator designed to improve hand and wrist movements under the microscope, enhance instrument handling and knot-tying skills, and consistently assess user performance.</div><div>Twenty-one surgical trainees participated in 3-day introductory microsurgical skills courses. Participants performed 2 predefined coordination exercises, “slalom” and “tie-the-knot,” before and after the course. The time required to complete the exercises was recorded. The videos of the exercises were anonymized, randomized, and evaluated by 3 independent raters—a senior experimental microsurgeon, a senior clinical microsurgeon, and a junior resident—using the Stanford Microsurgery Residents Training Scale. Participants also completed demographic and face validity questionnaires at the end of the course.</div><div>Quantitative analysis of pre-course scores vs post-course scores showed a statistically significant improvement in all examined skills. Moreover, the face validity assessment revealed highly positive feedback from the participants. The vast majority of candidates found the device extremely or very useful as an initial training model in microsurgery. Moreover, the model demonstrated its ability to discriminate between skill levels before and after training, supporting its construct validity. As a low-cost and accessible model, it provides a standardized approach for developing essential microsurgical skills. This simulator has the potential to serve as an effective assessment and training tool for students, residents, and microsurgical novices, contributing to improved skill acquisition in microsurgical training programs.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 162-169"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 3D surface and landmark-based analysis methods: The reliability and efficiency in determining asymmetry after facial palsy","authors":"Selin Eroglu ,&nbsp;Ozlem Ozsoy ,&nbsp;Yilmaz Yildirim ,&nbsp;Umut Ozsoy ,&nbsp;Hilmi Uysal","doi":"10.1016/j.bjps.2025.02.049","DOIUrl":"10.1016/j.bjps.2025.02.049","url":null,"abstract":"<div><h3>Background</h3><div>Our study sought answers on the reliability and sensitivity of landmark and 3D surface-based methods in detecting facial asymmetry.</div></div><div><h3>Methods</h3><div>Asymmetry analysis was performed using anatomical landmarks and surfaces from data obtained with a 3D scanner, and the amount of deviation was calculated according to the opposite half of the face. Resting, eyebrow-raising, eye closure, showing teeth, and whistling facial expressions were evaluated. The intraclass correlation coefficient (ICC) was used to calculate the method's reliability, and sensitivity in detecting asymmetry was tested by comparing healthy subjects and patients with the unpaired t-test. Seventeen patients and 20 healthy volunteers were analyzed.</div></div><div><h3>Results</h3><div>Intraobserver and interobserver agreement of surface-based analysis ranged from high to excellent in healthy and facial paralysis individuals (ICC 0.77 to 0.99), while landmark-based analyses ranged from moderate to high agreement (ICC 0.60 to 0.91). Furthermore, for the sensitivity in detecting asymmetry, while the landmark-based system could detect statistically significant differences in 2 (eyebrow-raising and showing teeth) of 5 facial expressions (sensitivity = 0.4), the 3D system could detect differences in 5 of 5 (sensitivity = 1) (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The 3D surface-based analysis method is more sensitive and reliable than the landmark-based method in determining facial asymmetry.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 469-478"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical modeling of finger flexion based on imaging data: Implications on trigger finger surgery","authors":"Younggeol Cho ,&nbsp;Ji Sup Hwang ,&nbsp;Kyung-Soo Kim ,&nbsp;Hyun Sik Gong","doi":"10.1016/j.bjps.2025.02.047","DOIUrl":"10.1016/j.bjps.2025.02.047","url":null,"abstract":"<div><h3>Purpose</h3><div>The risk of bowstringing increases significantly after an excessive release of the A2 pulley in patients with trigger finger. However, the safe extent of this release has not yet been determined. Using a biomechanical model of finger flexion, we examined tendon excursion efficiency and moment arms relative to finger joints. This analysis allowed us to determine the safe extent of A2 pulley release.</div></div><div><h3>Methods</h3><div>Computed tomography and magnetic resonance imaging data of eight subjects were used for the modeling. We simulated the incremental release of the A1 and A2 pulleys and compared moment at the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints for each degree of the release. In addition, we calculated the excursion length of the flexor digitorum profundus (FDP) necessary for achieving maximum PIP joint flexion.</div></div><div><h3>Results</h3><div>With respect to the MCP joint, the moment arm remained unchanged throughout the pulley release. However, with respect to the PIP joint, the moment arm increased significantly when the release reached the proximal half of the A2 pulley. For maximum PIP joint flexion, a significantly larger FDP excursion was required when half of the A2 pulley was released than in the intact finger (26.6 mm vs. 16.3 mm).</div></div><div><h3>Conclusions</h3><div>Our imaging-based biomechanical model of finger flexion effectively evaluated tendon excursion efficiency and moment arms with respect to the MCP and PIP joints according to the precise level of pulley release. The model demonstrated that extending the release up to the proximal half of the A2 pulley increases the risk of bowstringing. This imaging-based biomechanical modeling may be applied to predict tendon excursion efficiency after various hand surgeries.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 153-161"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Qualitative Assessment of Velopharyngeal surgery on patients and primary caregivers using VELO-P score in older children","authors":"Taruna Singh ,&nbsp;K. Rajarajeswari ,&nbsp;Akshay Kapoor ,&nbsp;Debarati Chattopadhyay","doi":"10.1016/j.bjps.2025.02.048","DOIUrl":"10.1016/j.bjps.2025.02.048","url":null,"abstract":"<div><h3>Introduction</h3><div>When there is insufficient closure of the velopharyngeal sphincter, speech sounds may be affected, leading to a condition known as Hypernasality. The impact of VPI extends beyond the physical aspects of speech and swallowing, affecting psychosocial aspects of life as well. Individuals with VPI may experience frustration, embarrassment, or self-consciousness due to their speech and swallowing difficulties. Early intervention and ongoing support can significantly improve outcomes and help individuals with VPI lead more fulfilling lives. We studied the satisfaction of the primary caregiver of children undergoing velopharyngeal surgery.</div></div><div><h3>Method</h3><div>We undertook a retrospective observational study with 28 participants. A 26-item parent-VELO (VELO-P) questionnaire was used to record the response of one primary caregiver.</div></div><div><h3>Results</h3><div>Twenty-eight patients with velopharyngeal insufficiency presenting to us in the outpatient department were included in the study. The average age of cases included was 13.85 years. all values had a significant improvement post-operatively with p value&lt; 0.001.</div></div><div><h3>Conclusion</h3><div>Using the VELO-P questionnaire, our study points out the positive influence on the patient's interactions with peers and family in VPI individuals and their caregivers.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"103 ","pages":"Pages 342-344"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DiffErential attainment and Factors AssoCiated with Training applications and Outcomes (DE FACTO) study: plastic surgery in the United Kingdom","authors":"Sarika Grover ,&nbsp;Siddarth Raj ,&nbsp;Martina Spazzapan ,&nbsp;Beth Russell ,&nbsp;Ayush K. Kapila ,&nbsp;Sachin Malde ,&nbsp;Stella Vig ,&nbsp;Simon Fleming","doi":"10.1016/j.bjps.2025.02.052","DOIUrl":"10.1016/j.bjps.2025.02.052","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"103 ","pages":"Pages 380-383"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter comments on: ‘A systematic review of wide alveolar cleft repair techniques’","authors":"Vaibhav Sahni","doi":"10.1016/j.bjps.2025.02.038","DOIUrl":"10.1016/j.bjps.2025.02.038","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"103 ","pages":"Page 263"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-stage prepectoral breast reconstruction: A comprehensive review and meta-analysis","authors":"Riccardo Di Giuli ,&nbsp;Mattia F. Cavallero ,&nbsp;Camilla Ferrari ,&nbsp;Stefano Vaccari ,&nbsp;Flavio Bucci ,&nbsp;Valeria Bandi ,&nbsp;Francesco M. Klinger ,&nbsp;Valeriano Vinci","doi":"10.1016/j.bjps.2025.02.041","DOIUrl":"10.1016/j.bjps.2025.02.041","url":null,"abstract":"<div><h3>Background</h3><div>Implant-based breast reconstruction is the most used approach for breast reconstruction following mastectomy. Prosthetic breast reconstruction helps achieve optimal results with reduced operation time, offering advantages over direct-to-implant and subpectoral reconstruction in selected patients. This study aimed to provide a comprehensive overview of the two-stage prepectoral breast reconstruction.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed, and the search was conducted across the PubMed, Cochrane, and Embase databases by adhering to the preferred reporting items for systematic reviews and meta-analysis guidelines. The inclusion criteria encompassed clinical trials or randomized clinical trials related to completed two-stage prepectoral breast reconstruction. Statistical analyses were conducted to synthesize the data and evaluate outcomes.</div></div><div><h3>Results</h3><div>A total of 48 articles were included for analysis, evaluating 4461 patients and 3894 breasts. The most commonly performed mastectomy type was skin-sparing mastectomy, followed by nipple-areola complex-sparing mastectomy. For the first surgical step, the mean tissue expander size was 423.64 cc, with a mean final expander fill of 349.10 cc. The mean time between the first and second surgery stages was 6.21 months, and the mean follow-up time was 17.10 months. A total of 21.27% of the patients experienced at least one complication. Specifically, seroma was identified in 11.19%, infection in 8.97%, skin flap necrosis in 8.48%, capsular contracture in 6.74%, rippling/wrinkling in 11.30%, expander or implant exposure in 2.38%, and implant removal in 8.62% of the patients.</div></div><div><h3>Conclusions</h3><div>Two-stage prepectoral breast reconstruction is a viable surgical option for selected patients. The most frequent complication was seroma. Adjuvant radiotherapy was associated with a higher rate of infection and implant removal.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 388-397"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilomatrixoma: A comprehensive 32-year analysis of clinical and histopathological findings of 1235 patients treated at Mayo Clinic","authors":"Rou Wan ,&nbsp;Elameen A. Adam ,&nbsp;Alexandre Meira Pazelli ,&nbsp;Samir Mardini ,&nbsp;Dawn Davis ,&nbsp;Julia S. Lehman ,&nbsp;Waleed Gibreel","doi":"10.1016/j.bjps.2025.02.044","DOIUrl":"10.1016/j.bjps.2025.02.044","url":null,"abstract":"<div><div>Research on pilomatrixoma has been limited, with most publications being case series or secondary reviews. This study aimed to analyze data from 1235 cases of pilomatrixoma to provide comprehensive information on demographic distribution, clinical presentations, and histopathological features of pilomatrixoma. A retrospective review was conducted between 1992 and 2024. The pathology database revealed 1235 confirmed cases. There was no significant sex predilection. The age distribution showed a bimodal pattern, with a childhood peak and a second, lower peak between ages 50 and 75 years (mean, 41.3±25.6 years; range, 6 months-92 years). The most common location was the head (45.1%). Multiple occurrences were rare (4%), and we found an association between increased age and decreased risk of multiple manifestations (OR=0.97, P&lt;0.001). Forty patients (3.2%) were reported to have genetic syndromes. Pilomatrixoma was considered in the preoperative diagnosis in 490 cases (37.2%). Additionally, pilomatrixoma with atypical or proliferating features was detected in 24 cases (1.8%). Logistic regression revealed that age is a predictor for the likelihood of developing proliferating or atypical pilomatrixoma (OR=1.04, P&lt;0.001). Among the 137 cases with preoperative imaging, ultrasonography was used the most, but the sensitivity was 29.2%. The recurrence rate was 2.4% among our sample. Recurrence showed no association with age, location, procedure type, pilomatrixoma size, or pathological findings. In conclusion, pilomatrixomas are infrequently suspected preoperatively. Considering the patient's age, the size and location of the lesion may help distinguish it from other benign masses. Recurrence or malignant transformations are extremely rare after complete removal.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 245-252"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of differences in eye tracking and gaze patterns of three different surgical incision scars for nipple-sparing mastectomy on immediate postoperative aesthetics of breast reconstruction","authors":"Zexiong Cheng ,&nbsp;Zhechen Zhu ,&nbsp;Wei Yan ,&nbsp;Chi Zhang ,&nbsp;Jingping Shi","doi":"10.1016/j.bjps.2025.02.032","DOIUrl":"10.1016/j.bjps.2025.02.032","url":null,"abstract":"<div><div>The prevalence of breast cancer has been increasing globally, with a notable impact on women’s health. To address the aesthetic outcomes of different surgical incision scars following nipple-sparing mastectomy for breast cancer, this study employed eye-tracking technology for the objective recording of observation patterns. The impact of 3 distinct scar types (transverse, discontinuous, and contiguous) on breast-viewing behavior was analyzed in total. The researchers requested that participants view images of breasts with these scars and subsequently rate the visibility of the scars on a visual analog scale. The results were then collected and analyzed. The findings indicated that contiguous scars were observed for the longest duration and were perceived as the most obvious. They were considered the least aesthetically pleasing, likely due to their proximity to and partial intersection with the nipple-areola complex (NAC). In contrast, discontinuous scars were associated with shorter gaze durations and were considered more aesthetically pleasing. These findings indicate that the selection of surgical incisions is of significant importance with regard to postoperative breast aesthetics. Furthermore, they suggest that the avoidance of the NAC area may facilitate superior aesthetic outcomes. Moreover, the present study did not find a significant effect of breast size and gender on the assessment of postoperative aesthetic outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 124-131"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative complications of ADM use in previously irradiated patients during stage I of implant-based breast reconstruction: A national database propensity score-matched analysis","authors":"Devi Lakhlani ,&nbsp;Elaine Lin ,&nbsp;Adira Kruayatidee ,&nbsp;Robin Wu ,&nbsp;Christian Palacios ,&nbsp;Clifford Sheckter ,&nbsp;Rahim Nazerali","doi":"10.1016/j.bjps.2025.02.042","DOIUrl":"10.1016/j.bjps.2025.02.042","url":null,"abstract":"<div><h3>Introduction</h3><div>Acellular dermal matrix (ADM) is widely used in implant-based reconstruction to prevent capsular contracture, but its safety in irradiated patients is underexplored. We aimed to evaluate postoperative complications associated with ADM use in stage I of implant-based breast reconstruction in patients with premastectomy radiation.</div></div><div><h3>Methods</h3><div>Using the Merative MarketScan Research Databases, 2012–2020, previously irradiated patients undergoing outpatient stage I implant breast reconstruction (prepectoral and submuscular) were stratified by ADM use and propensity score-matched. Postoperative complications and additional surgical interventions within 90 days were analyzed using multivariate logistic regression.</div></div><div><h3>Results</h3><div>Among 1234 matched patients (617 ADM and 617 non-ADM), ADM use was first recorded in 2012, and its frequency showed a positive correlation over the study (r = 0.214, p &lt;.001). Patients with ADM experienced higher rates of wound (8.5% vs. 7.8%) and tissue necrosis (5.5% vs. 4.0%) than non-ADM patients, but these differences were not statistically significant. Additionally, no significant differences were observed between ADM and non-ADM groups in the rates of seroma formation, hematoma, fat necrosis, or postoperative infections. ADM use was associated with significantly lower odds of requiring image-guided fluid drainage for hematomas or seromas (OR 0.11, 95% CI 0.01–0.89, p =.039).</div></div><div><h3>Conclusion</h3><div>No significant difference in complication rates was found between previously irradiated breast cancer patients with and without ADM on a large scale, even with ADM usage increasing over time. Its adoption should balance cost, surgeon preferences, and esthetic outcomes, with further research needed on its role in various reconstruction planes and cost impacts.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 181-190"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}